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Описание: Schizoid personality disorder (/ˈskɪtsɔɪd, ˈskɪdzɔɪd, ˈskɪzɔɪd/, often abbreviated as SzPD or ScPD) is a personality disorder characterized by a lack of interest in social relationships,[9] a tendency toward a solitary or sheltered lifestyle, reservedness, emotional coldness, detachment, and apathy.[10] Affected individuals may be unable to form intimate attachments to others and simultaneously possess a rich and elaborate but exclusively internal fantasy world.[11] Other associated features include stilted speech, a lack of deriving enjoyment from most activities, feeling as though one is an "observer" rather than a participant in life, an intolerance towards meeting emotional expectations of others, apparent indifference when praised or criticized, being on the asexual spectrum, and idiosyncratic moral or political beliefs.[12]

Symptoms typically start in late childhood or adolescence.[10] The cause of SzPD is uncertain, but there is some evidence of links and shared genetic risk between SzPD, other cluster A personality disorders, and schizophrenia.[13][14][15][16][17] Thus, SzPD is considered to be a "schizophrenia-like personality disorder".[3][18] It is diagnosed by clinical observation, and it can be very difficult to distinguish SzPD from other mental disorders or conditions (such as autism spectrum disorder, with which it may sometimes overlap).[19][20]

The effectiveness of psychotherapeutic and pharmacological treatments for the disorder has yet to be empirically and systematically investigated. This is largely because people with SzPD rarely seek treatment for their condition.[10] Originally, low doses of atypical antipsychotics were used to treat some symptoms of SzPD, but their use is no longer recommended.[21] The substituted amphetamine bupropion may be used to treat associated anhedonia.[4] However, it is not general practice to treat SzPD with medications, other than for the short-term treatment of acute co-occurring disorders (e.g. depression).[22] Talk therapies such as cognitive behavioral therapy (CBT) may not be effective, because people with SzPD may have a hard time forming a good working relationship with a therapist.[10]

SzPD is a poorly studied disorder, and there is little clinical data on SzPD because it is rarely encountered in clinical settings. Studies have generally reported a prevalence of less than 1%.[3][8][23] It is more commonly diagnosed in males than in females.[8] SzPD is linked to negative outcomes, including a significantly compromised quality of life, reduced overall functioning even after 15 years, and one of the lowest levels of "life success" of all personality disorders (measured as "status, wealth and successful relationships").[5][24][25] Bullying is particularly common towards schizoid individuals.[26][27] Suicide may be a running mental theme for schizoid individuals, though they are not likely to attempt it.[28] Some symptoms of SzPD (e.g. solitary lifestyle, emotional detachment, loneliness, and impaired communication), however, have been stated as general risk factors for serious suicidal behavior.[29][30]
Signs and symptoms
Social isolation
People with SzPD are often socially isolated.

SzPD is associated with a dismissive-avoidant attachment style.[31][32][33][34] People with this disorder will rarely maintain close relationships and often exclusively choose to participate in solitary activities.[35][36][37] People with schizoid personality disorder typically have no close friends or confidants, except for a close relative on occasions.

They usually prefer hobbies and activities that do not require interaction with others.[38][39] People with SzPD may be averse to social situations due to difficulties deriving pleasure from physical or emotional sensations, rather than social anhedonia.[40][41]

One potential motivation for avoiding social situations is that they feel that it intrudes on their freedom.[42][43] Relationships can feel suffocating for people with SzPD,[44] and they may think of them as opportunities for entrapment.[5][45]

Patients with this disorder are often independent and turn to themselves as sources of validation. They tend to be the happiest when in relationships in which their partner places few emotional or intimate demands on them and does not expect phatic or social niceties. It is not necessarily people they want to avoid, but negative or positive emotional expectations, emotional intimacy, and self-disclosure.[46][47]

Patients with SzPD can feel as if close emotional bonds are dangerous to themselves and others.[48][43][49] They may have feelings of inadequacy or shame.[50] Some people with SzPD may experience a deep desire to connect with others, yet will be terrified by the dangers inherent in doing so.[43][51] Avoidance of social situations may be a method of avoiding being hurt or rejected.[52][53]